Adolescents with psychopathology who also experience psychotic symptoms have a nearly 70-fold increased odds of acute suicide attempts, according to new research. This information, the authors noted, may help develop clinical markers for suicide risk and should improve suicide assessment success. The results of the prospective cohort study was published in JAMA Psychiatry.1

Researchers followed 1112 school-based adolescents (aged 13 to 16 years), who were assessed at baseline and then again at 3 and 12 months for self-reported psychopathology, psychotic symptoms, and suicide attempts. At the 3-month mark, only 1% of those without baseline psychotic symptoms reported suicide attempts; meanwhile, 7% of those adolescents who reported psychotic symptoms at baseline reported suicide attempts. At 12 months, the number of adolescents who attempted suicide jumped to 20% for those who reported psychotic symptoms at baseline, compared with 2.5% for those without psychotic symptoms. The numbers were even higher for those adolescents with both psychopathology psychotic symptoms, with 14% and 34% attempting suicide by 3 months and 12 months, respectively.

The researchers explained, “Psychotic symptoms may be a marker of increasing severity of psychopathology, including increased nonpsychotic psychiatric symptom burden and multimorbidity, that indexes risk for suicidal behavior.”1

Clinically, they added, this research shows “the need for a new clinical focus on careful assessment of psychotic symptoms (both attenuated and frank) in patients with nonpsychotic disorders; this should be considered a key element of suicide risk assessment.”1